Introduction

I wish, first of all, to congratulate the High Commissioner for Human Rights for hosting this timely side-event on ‘Migrants and the Right to Health’. It keeps up the momentum this theme is gaining globally. I also congratulate the Permanent Mission of Thailand – in particular Ambassador Thani Thogphakdi for his leadership and commitment in championing the health of migrants and express gratitude to all the other co-hosts: Mexico, Bangladesh, Ghana, the Philippines, and Thailand.   

This event is mean to remind us that migration is ultimately about human beings. Migrants, just like the rest of us, have the right to enjoy the highest attainable standards of health.

IOM is very pleased that this issue is now attracting international attention. Four examples include:

a) I recall, for instance, the Regional Workshop on Migrants' Health hosted by the Ministry of Foreign Affairs of the Royal Government of Thailand in August 2015, to reflect on the importance of promoting an inclusive health system for migrants.
b) In IOM’s Council we have addressed the issue through a High-Level Panel on Migration, Human Mobility and Global Health; an event in which the Advisor to the Minster of Foreign Affairs of Thailand participated as well as WHO DG Margaret Chan.
c) WHO has taken the matter up at a High-Level Meeting on Refugee and Migrant Health organized by WHO-EURO.
d) WHO has also discussed the Promotion of the Health of Migrants at its 138th Executive Board Session.

I shall address three points in this brief presentation:

1. Migrant Health in an era of unprecedented human mobility: the global context
2. Migrant health as a key ingredient in migrant integration
3. Migration Health requires partnership

I. Migrant Health in an era of unprecedented human mobility: the global context

We live in an era of unprecedented human mobility -- a period in which more people are on the move than ever before. We are facing an unprecedented level of forced migration compounded by an unparalleled number of simultaneous, complex, protracted crises involving armed conflicts, political upheavals, natural disasters, and abject poverty – ranging from the Western bulge of Africa all the way to the Bay of Bengal.

Not since the Second World War have so many persons been forcibly displaced, a number exceeding 60 million. Humanitarian crises force people to flee their homes in search of safer places and frequently generate prolonged displacement, which in turn can sweep away hard-won development gains. All of these factors exacerbate the number of mixed migration flows all over the world.

Vulnerability along migratory routes is also health vulnerability – making access to health all the more critical.

Kate Gilmore has described the precarious situation of migrants along the migratory route. Irregular migrants are reluctant to seek medical care because of their irregular status. 

The most important challenge we face today, however, lies not in the numbers. It lies in the fact that our migration policies have not kept pace with human realities. There is a disjuncture between contemporary patterns and processes of forced migration, and the current legal and frameworks to protect forced migrants. The increasingly visible, unintended consequences of the current system call for a new way of thinking about protection, development, and humanitarian response.

Migration practitioners the world over are therefore pleased that the Sustainable Development Goals adopted by world leaders in 2015 clearly acknowledge the significance of migration. No longer is human mobility seen as a matter of peripheral interest or worse, simply as a consequence of lack of development. Migration is identified as a driver and enhancer of sustainable development.

In parallel with this, we need to change the current toxic public narrative on migration to one that takes full account of the contribution migrants make to the development of both their countries of origin and development; and in so doing, make the case for societies tolerant of diversity. Diverse societies are strong, culturally rich and intellectual prosperous, provided that the physical and psychosocial needs of its members are attended to. It is a stereotype to say that migrants move in order to take advantage of free health services.

What does this mean for migrant health? This leads me to my second point.

II. Migrant health as a key ingredient in migrant integration

The weakest aspect in migration policies is often migrant health, yet migrant health is a key to successful integration.

Health is a basic human right and an essential component of sustainable development. Being and staying healthy is a fundamental precondition for migrants to work, to be productive and to contribute to the social and economic development of their communities of origin and destination.

Migration and population mobility and associated risk factors are increasingly being recognized as determinants of health for migrant and mobile populations and host communities. Migration can expose individuals to vulnerabilities and risks that are exacerbated: inaccessibility to or unavailability of healthcare services, severe stress caused by the journey, poor living and working conditions and the changing global security landscape. All of these challenges require close attention.

It is important to emphasize that Migrants and Mobile Populations (MMPs) do not generally pose a risk to health for hosting communities and migrants should not be stigmatized or stereotyped and associated with the risk of importing diseases. It is rather the conditions surrounding the migration process that can increase the vulnerability of MMPs and host communities to ill health. Migration processes can positively or negatively affect health outcomes, just as health status can affect migration outcomes. In that sense, migration is a social determinant of health.

Migration exposes individuals to risks and vulnerabilities which are often exacerbated by factors such as:

i) lack of, or inaccessibility to, healthcare services, particularly for those who find themselves in a situation of irregularity;
ii) the perilous context within which the migration process often takes place;
iii) the poor living and working conditions encountered by migrants; which are often determined by
iv) stigma, discrimination, and anti-migrant sentiment in societies.

Current health strategies and practices were designed to meet the needs of populations perceived as static and homogenous. Yet, modern migration and globalization have brought new challenges to health systems and societies, including diversity, interconnectivity, and high levels of rapid population mobility both within and across national borders. Successful integration of migrants into health systems is therefore critical to a) predict and head off the future spread of diseases; b) design evidence-informed responses along mobility pathways; and c) to enhance national capacities to promote the health of migrants more effectively. If targeted outreach health services and surveillance along mobility pathways are weak – or lacking altogether, the effectiveness of public health services is undermined and migrants are made vulnerable to stigmatization and discrimination. All of these considerations argue for the integration of migrants in health systems regardless of their status or condition. Ultimately it is in the local and national interest to ensure migrants access to health care. After all, healthy migrants make healthy communities.

III. Migration Health Requires Partnership

So, what can we, the international community, do to improve migrant health? Let me offer four suggestions:

1. First, we must raise the profile of migrant health. Human mobility must be mainstreamed into global health and human rights agendas. Furthermore, a migrant-centered, multi-sectoral approach is necessary for the widespread promotion of the health of MMPs within the context of the overall public health of societies. 

2. Second, we need to work in partnership. Fragmented initiatives rarely produce worthwhile results. We must work together to bettering of understand health aspects of mobility and to develop complementary programmes of action

3. Third, we must promote migrant-friendly healthy policies creating more opportunities for migration and health stakeholders to meet and consult about the ways and means to do so. One such opportunity is the 2nd Global Consultation which will be hosted by Sri Lanka and co-organized by IOM and other partners in October this year.

4. To address these challenges relating to the health and well-being of migrants, we need to build a platform connecting health, human mobility, human rights and equity in our globalized and interconnected world; as well as strong leadership across all sectors and across all borders. It requires an innovative, systematic, multi-disciplinary and multi-sectoral approach, of which new partnerships and health diplomacy are a prerequisite. Therefore, partnerships, both across sectors of society and across borders, can help to turn existing challenges into opportunities for improving the health of migrants.

Conclusion

For its part, IOM is committed to working with partners in addressing the public health challenges posed by the rapidly evolving nature of human mobility. One in every 10 of IOM’s 10,000 staff worldwide in 480 sites is medical staff. We just medically examined 25,000 Syrian refugees over the yearend holidays and transported them to Canada.

IOM strongly advocates and promotes the protection and integration of MMPs into societies through migration-sensitive health systems. IOM highlights the contribution of migrants to development and stability when they are healthy and enabled to stay healthy.